Individual provider Active NPI

Jan-Mario Dejean, M.D.

  • Emergency Medicine Physician
  • South Miami, FL
National Provider Identifier
1952489296
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME0062955 Issued in FL
Practice address
7031 SW 62ND Ave
Emergency Room
South Miami, FL 33143-4701
Phone
(305) 284-7600
Fax
(305) 284-7607
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME0062955 FL Primary

Addresses

Primary practice location

7031 SW 62ND Ave
Emergency Room
South Miami, FL 33143-4701

Mailing address

305 NE 148TH St
North Miami, FL 33161-2052
Phone (305) 284-7655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0062955FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Radiological Services PC Past Accepting new patients
CMC Radiological Services PC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952489296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 NE 148TH ST",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331612052",
            "telephone_number": "305-284-7655",
            "fax_number": "305-284-7763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7031 SW 62ND AVE",
            "address_2": "EMERGENCY ROOM",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434701",
            "telephone_number": "305-284-7600",
            "fax_number": "305-284-7607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJEAN",
        "first_name": "JAN-MARIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME0062955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.